School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
J Glob Antimicrob Resist. 2019 Dec;19:116-121. doi: 10.1016/j.jgar.2019.03.007. Epub 2019 Mar 20.
Antimicrobial resistance (AMR) has become a serious global public health problem. The World Health Organization (WHO) and European Union (EU) have taken actions to combat this issue, in which laboratory capability construction is a crucial part. This study aimed to explore the relationship between laboratory capabilities and antimicrobial resistance from a macro perspective.
The study used annual national level penal data from the EU Laboratory Capability Monitoring System and Antimicrobial Resistance Surveillance Europe 2013-2016. A conventional static panel data analysis was constructed to establish the relationship between the antimicrobial resistance rates and laboratory capabilities.
Laboratory capability on antimicrobial drug resistance characterisation and monitoring (LC8) showed a positive effect on Escherichia coli (E. coli) combined resistance rate (Y5), E. coli resistant rate of aminoglycosides (Y4), and Klebsiella pneumoniae resistant rate of carbapenems (Y8) (OR=0.929, 0.957, and 0.861; P=0.035, 0.007, and 0.026, respectively). However, following the diagnostic testing guidelines (LC2) caused higher resistance rates of Klebsiella pneumoniae to fluoroquinolones (Y6), third-generation cephalosporins (Y7), and aminoglycosides (Y9) (OR=1.076, 1.093, and1.065; P=0.011, 0.032, and 0.002, respectively).
Antimicrobial drug resistance characterisation and monitoring by laboratories has contributed to minimising antimicrobial resistance, while the mechanism of laboratory capabilities to pose an ineffective or negative impact on AMR remains to be further studied.
抗菌药物耐药性（AMR）已成为严重的全球公共卫生问题。世界卫生组织（WHO）和欧盟（EU）已采取行动应对这一问题，其中实验室能力建设是一个关键部分。本研究旨在从宏观角度探讨实验室能力与抗菌药物耐药性之间的关系。
本研究使用了欧盟实验室能力监测系统和 2013-2016 年欧洲抗菌药物耐药性监测的年度国家级处罚数据。构建了常规静态面板数据分析，以建立抗菌药物耐药率与实验室能力之间的关系。
抗菌药物耐药性特征和监测（LC8）实验室能力对大肠埃希菌（E. coli）联合耐药率（Y5）、氨基糖苷类耐药率（Y4）和碳青霉烯类耐药率（Y8）呈正相关（OR=0.929、0.957 和 0.861；P=0.035、0.007 和 0.026）。然而，遵循诊断测试指南（LC2）会导致肺炎克雷伯菌对氟喹诺酮类（Y6）、第三代头孢菌素（Y7）和氨基糖苷类（Y9）的耐药率更高（OR=1.076、1.093 和 1.065；P=0.011、0.032 和 0.002）。
实验室的抗菌药物耐药性特征和监测有助于最大限度地减少抗菌药物耐药性，而实验室能力对 AMR 产生无效或负面影响的机制仍需进一步研究。
